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Doubt over combination to lower BP

An NHS report has concluded there is little justification for prescribing ACE inhibitors and angiotensin II receptor antagonists together for hypertension, renal disease and heart disease despite positive results from several large trials.

The National Prescribing Centre warned that for hypertension and heart failure the efficacy or safety of combination treatment has not been proven. In renal disease use of the combination is extremely complex and should be overseen by a specialist, it advises.

Rather that putting patients on combination therapy, the report recommends making sure they are receiving the optimum ACE inhibitor dose and considering whether they are suitable for ?-blockers and/or spironolactone.

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